Background: Cardiorenal syndrome (CRS) represents a bidirectional dysfunction between the heart and kidneys, complicating clinical management, particularly in acute care settings. Its burden and characteristics in North African populations remain underexplored.

Objective: To describe the clinical profile, subtype distribution, and outcomes of patients with CRS admitted to a Moroccan emergency department.

Methods: We conducted a retrospective observational study of 40 patients diagnosed with CRS between January 2022 and October 2023 at the Ibn Sina University Hospital, Rabat. Data included demographics, comorbidities, laboratory, ECG, echocardiographic findings, treatment modalities, and in-hospital outcomes.

Results: The mean age was 59.7 ± 13.6 years; 60% were female. Hypertension (67.5%) and diabetes (40%) were the most common comorbidities. CRS type 1 was the most prevalent (80%), followed by type 3 (10%). ECG abnormalities included left atrial hypertrophy (47.5%) and left ventricular hypertrophy (37.5%). Transthoracic echocardiography revealed systolic dysfunction in 52.5% of cases. Diuretics were used in 97.5% and non-invasive ventilation in 90%. Hemodialysis was required in 10%. The in-hospital mortality rate was 17.5%, with age >70 and septic shock significantly associated with death (p<0.05).

Conclusion: CRS is a serious condition frequently encountered in emergency settings, particularly in its acute form. Early recognition and multidisciplinary management are crucial to improving outcomes. This study adds valuable epidemiological data on CRS in North Africa and underscores the need for context-specific protocols.